Olsen M, Davis E T, Waddell J P, Schemitsch E H
Division of Orthopaedic Surgery, Department of Surgery, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8.
J Bone Joint Surg Br. 2009 Mar;91(3):310-5. doi: 10.1302/0301-620X.91B3.21288.
We have investigated the accuracy of placement of the femoral component using imageless navigation in 100 consecutive Birmingham Hip Resurfacings. Pre-operative templating determined the native neck-shaft angle and planned stem-shaft angle of the implant. The latter were verified post-operatively using digital anteroposterior unilateral radiographs of the hip. The mean neck-shaft angle determined before operation was 132.7 degrees (118 degrees to 160 degrees ). The mean planned stem-shaft angle was a relative valgus alignment of 9.7 degrees (SD 2.6). The stem-shaft angle after operation differed from that planned by a mean of 2.8 degrees (SD 2.0) and in 86% of cases the final angle measured within +/- 5 degrees of that planned. We had no instances of notching of the neck or varus alignment of the implant in our series. A learning curve was observed in the time taken for navigation, but not for accurate placement of the implant. Navigation in hip resurfacing may afford the surgeon a reliable and accurate method of placement of the femoral component.
我们对连续100例伯明翰髋关节表面置换术中使用无影像导航技术放置股骨部件的准确性进行了研究。术前模板测量确定了患者自身的颈干角以及植入物计划的柄干角。术后通过髋关节的数字化前后位单侧X线片对后者进行验证。术前确定的平均颈干角为132.7度（范围118度至160度）。计划的平均柄干角为相对外翻9.7度（标准差2.6）。术后柄干角与计划值的平均差异为2.8度（标准差2.0），86%的病例最终测量角度在计划值的±5度范围内。在我们的系列病例中，没有出现颈部切迹或植入物内翻对线的情况。在导航所需时间方面观察到了学习曲线，但在植入物的准确放置方面未观察到学习曲线。髋关节表面置换术中的导航可能为外科医生提供一种可靠且准确的股骨部件放置方法。
